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阿那白滞素治疗1例难治性成人斯蒂尔病及文献复习
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| 篇名： | 阿那白滞素治疗1例难治性成人斯蒂尔病及文献复习 |
| TITLE： | A case report and literature review on anakinra in the treatment of refractory adult onset Still’s disease |
| 摘要： | 目的 探讨白细胞介素1（IL-1）受体拮抗剂阿那白滞素治疗难治性成人斯蒂尔病（AOSD）的疗效与安全性，为该药治疗AOSD提供更多的真实世界证据和实践经验。方法回顾性分析1例AOSD合并皮肌炎患者应用阿那白滞素的诊疗过程；在中国知网、PubMed、Medline等中英文数据库中系统检索阿那白滞素治疗AOSD的相关文献，对其疗效与安全性进行文献复习。结果本例患者经多种传统药物治疗效果不佳，考虑为AOSD合并皮肌炎。入院改用阿那白滞素联合糖皮质激素治疗数天后，患者临床症状及炎症指标显著改善，未发生严重不良反应。药师为其设计专门的药学监护路径并在出院后定期随访。出院后患者规律用药，病情维持缓解；期间出现过一次注射部位红肿并自行缓解，无其他明显不适。文献复习显示，阿那白滞素可使AOSD患者具有较高的反应率和缓解率，可显著减少糖皮质激素用量；不良事件以注射部位反应为主，总体感染风险较低，安全性良好；但疗程差异较大，目前尚无统一方案。结论阿那白滞素是治疗AOSD的高效且安全的生物制剂，可快速诱导并维持病情缓解。对于AOSD患者，临床可考虑选用IL-1拮抗剂以减少糖皮质激素依赖，同时应加强长期用药监测。 |
| ABSTRACT： | OBJECTIVE To investigate the efficacy and safety of the interleukin-1 （IL-1） receptor antagonist anakinra in the treatment of refractory adult onset Still’s disease （AOSD）， and provide more real-world evidence and practical experience for the treatment of AOSD with this drug. METHODS A retrospective analysis was conducted on the diagnosis and treatment process of a patient with AOSD complicated with dermatomyositis who received anakinra； systematically searched for relevant literature on the treatment of AOSD with anakinra in Chinese and English databases such as CNKI， PubMed， Medline， etc.， and conduct literature review on its efficacy and safety. RESULTS The patient in this case had poor treatment with multiple traditional drugs and was considered to have AOSD combined with dermatomyositis. After being admitted to the hospital and treated with a combination therapy of anakinra and glucocorticoids for several days， the patient’s clinical symptoms and inflammatory indicators significantly improved， and no serious adverse drug reactions occurred. Pharmacists designed specialized pharmaceutical monitoring pathways and conduct regular follow-up after discharge. After discharge， the patient took medication regularly， and the condition was maintained and relieved； during this period， there was redness and swelling at the injection site which resolved on its own without any other obvious discomfort. Literature review showed that anakinra could increase the response rate and remission rate of AOSD patients， and significantly reduce the dosage of glucocorticoids； adverse events were mainly injection site reactions， with a low overall risk of infection and good safety； however， there was a significant difference in the treatment course， and there was currently no unified plan. CONCLUSIONS Anakinra is an efficient and safe biological agent for treating AOSD， which can rapidly induce and maintain disease remission. For AOSD patients， clinical consideration may be given to using IL-1 antagonists to reduce glucocorticoid dependence， while strengthening long-term medication monitoring. |
| 期刊： | 2025年第36卷第19期 |
| 作者： | 严钰敏；刘洁；张霞；钟雪 |
| AUTHORS： | YAN Yumin，LIU Jie，ZHANG Xia，ZHONG Xue |
| 关键字： | 阿那白滞素；成人斯蒂尔病；皮肌炎；白细胞介素1受体拮抗剂 |
| KEYWORDS： | anakinra； adult onset Still’s disease； derma- |
| 阅读数： | 5 次 |
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